Tag: placebo

Success with nicotine products

I hate to break this to you, smokers, but your government doesn’t want you to realise that NRT doesn’t work because they don’t really want you to stop smoking.

by Chris Holmes

A full eighteen months after Harvard University proved that nicotine replacement therapy “is no more effective in helping people stop smoking cigarettes in the long term than trying to quit on one’s own”, we might wonder why smokers are still being prescribed these useless products at the taxpayers’ expense. This is no longer an “evidence-based” medicine – in fact it is not a medicine at all and never has been. There is no such thing as “therapeutic nicotine”.

“Therapeutic” means it does you GOOD!

Nicotine is a poison. All the effects of nicotine are toxic, but the drug companies that produce nicotine replacement products have been funding research for years now, trying to find another application for the products because they know it won’t be long before all smokers know it doesn’t work at all. Every now and then stories pop up in the press reporting that “research suggests” that nicotine patches “might be useful” for this, or “could be helpful” for that.

The problem with “research”

Let us not forget that it was “research” which suggested in the first place that nicotine replacement poisoning “might be” helpful to smokers. The trouble is, they only looked at the short-term effects. This is what passes for “science” nowadays because research like this is organised and funded by the companies that make the products, and all they’re after is a licence. So those short-term effects don’t have to be impressive, they only have to be slightly better than a control group using a placebo. This is easy to organise: you just run several groups at the same time, some with placebos and some with the product, using only small numbers of people within each group.

Cherry picking

Why small numbers? Because when you convert that number into a percentage later, you magnify it. Then you cherry pick both ways: you take the placebo group with the lowest number of successes, and the product group with the highest. The difference in real numbers of successes may be no more than a random anomaly really, but as soon as you convert both figures into percentages it looks like a very clear and positive result. Sometimes they even stop clinical trials early because they have achieved that already and they don’t want to blunder on long enough to run into nasty side effects or relapses that may occur in the long term. It is okay for the end-user to blunder into that sort of thing, but we don’t want it mussing up the trial data.

Exclusions

Did I mention that we exclude anyone from the trials who might be fragile in any way mentally or physically? Just in case they don’t respond very well or have a bad reaction that might mess up the trial and make the drug look dangerous. Of course the end-user isn’t protected by being excluded. Doctors will prescribe it with confidence to anyone, because they fondly imagine that it has been proven in the trials to be effective and safe. It hasn’t.

The truth about NRT

The cruel truth is that nicotine replacement products are still being fraudulently funded by public money and recommended to smokers because it creates the impression that the government is doing something about smoking but in reality it does not reduce the tobacco tax revenue by being effective in stopping people smoking. In fact that official endorsement legitimises a bogus product which can also be bought over the counter, and the government collect Value Added Tax (meaningless phrase that, isn’t it?) from the sale of those products. Also, promoting methods that actually work – such as hypnotherapy, for example – would save lives, meaning that more people would live to retirement age and start claiming a pension when there are frankly too many people doing that already…

The truth about the Department of Health

So that is why, when the science proved that every penny of public money spent on nicotine products is completely wasted, the government pretended not to notice, just as they did when their own research came to the same conclusions in 2005 (the Borland Report). I hate to break this to you, smokers, but your government doesn’t want you to realise that NRT doesn’t work because they don’t really want you to stop smoking. They want you to smoke, then try the nicotine gum, then smoke, then try the patches, then smoke, then try the lozenges, then smoke, then try the microtab, then smoke, then try the nicotine spray, then relapse into smoking again and hopefully this will have taken so many years that you ALMOST get to retirement age but not quite.

And then they want you to die. That is what “success with nicotine products” means to them.

The Quacks, the Hacks and the Therapists

by Chris Holmes

Edzard Ernst, if we are to believe what certain hacks tell us, is in danger of losing his position at Exeter University – but it has nothing to do with his own behaviour, of course!  This is a link to a particularly lame piece from the Guardian’s Sarah Boseley which tries to suggest that the reason nobody seems to want to fund “the scourge of complementary medicine” is because The Prince of Wales has somehow made it so! Since when did he have the power to forbid the funding of University research, Sarah? Don’t be silly.

After 17 years of CAM-bashing, with hardly anything positive to say about Complementary Medicine at all, it could just be that everyone’s sick to death of the guy, except of course for all the pathological cynics like Sarah Boseley, Simon Singh, Ben Goldacre etc etc who seem to have the simplistic, collective notion that all CAM therapists are “quacks”.  The repeated suggestion they make in the media is that private therapists make vast fortunes by hoodwinking people who, because they are ‘deluded’ or ‘vulnerable’ pay willingly for therapies that they often seem quite happy with – only their opinion doesn’t count, because they’re ‘deluded’. How patronising is that?

The only thing that does count – according to these few self-appointed “quackbusters” – is the relentlessly negative outpourings of Ernst’s unit which can be summed up thus: whatever therapy he’s looking at, after a selective review of previous studies the verdict is that there’s no evidence that it works and it could even be dangerous! Yes, that’s right: it’s more or less the same verdict for everything he looks into!

This is exactly why most open-minded people have stopped taking him seriously. After all, if he were finding the very reverse with the same consistency – that ALL complementary therapies worked – how long would it be before everyone suspected his methods, eh? So he’s left with only the rabid hard-core of New Simple Scientism, which can equally be named Prejudice.

Has it not occurred to any of these people that for many, many years millions of people have been using these therapies and returning to them because they find them effective?  Not only that, but all those people have families and friends who will also have been aware of that, so although it is often said that only 25% of the population use CAM therapies, a hell of a lot more will have heard about the results.  The only people who dismiss those first-hand opinions are pathological cynics, and although those people are often noisy, opinionated and usually rude to anyone who tries to explain that they’ve got it wrong, they are actually in a very small minority.  They are the only people with an axe to grind about all this, and they aren’t doing that for the sake of the people who use CAM therapies at all!  They have nothing but contempt for people who use CAM therapies… but no-one else does.

So Ernst has had an exciting time, drawing attention to himself as the “scourge of Complementary Medicine” as Boseley rather tellingly put it – which is why she approves – forgetting that officially he is supposed to be objective.  But no-one normal who is aware of Ernst at all would ever regard him as impartial, he is quite clearly the champion of the pathological cynics and was from the start, although many people didn’t realise that straight away.

Some of these Ernst Groupies call themselves skeptics, but they are quite wrong to do so.  I work with skeptics all the time, and I don’t find their skepticism a problem at all.  Hypnotherapists are used to the fact that most new clients are skeptical, which is another reason I object to the term “faith-based therapies” which is repeatedly used to denigrate CAM therapies in general. Most of my new clients don’t have any particular faith in hypnotherapy, in fact they are usually very surprised by the results.  Of course we partly have the likes of Ernst to thank for that low level of expectation, but it is also partly caused by the fact that many of my clients will have tried to fix the problem through their own efforts previously with no lasting success, so their conscious expectations are fairly low because of that.

The “faith-based” suggestion is a snidey way of making out that the results don’t go beyond a placebo effect caused by their own delusions, which is extremely patronising and (in the case of hypnotherapy, for sure) utterly inaccurate.  Although the majority of people are fairly skeptical of all unfamiliar things, they are not cynics. Most people who try CAM therapies are simply being practical: if you want to get rid of a problem, you just try one thing after another until you find the thing that works for you.  If the cynics had their way, you wouldn’t have the choice: you would have to take what the doctor recommended even if it kills you (See ‘Trust Me, I’m a Doctor’ on this site, and also the blogpost ‘Daily Mail Article’ in the blog category Drugs On Trial.) 

When I was growing up, if someone said they were “off to see the quack” they meant the doctor, their General Practitioner.  Lately the word has been used by the cynics and a few opinionated hacks to attack the entire field of Complementary Medicine, and what these people are forgetting is that the only people who will agree with those mocking, patronising and extremely negative and ignorant opinions are the cynics of the world.  Edzard Ernst’s publications haven’t made those people the way they are, they were like that already.  He just gave them – briefly – more credibility because of his bogus title and his academic position, but his “don’t shoot the messenger” suggestion that he uses to deflect criticism is a pathetic attempt to erase himself from “the science”, and nobody with any intelligence will fall for that one!  So, all published studies are simply “the truth” are they, Edzard?  Never mind the intent, never mind the funding, never mind the methodologies… the studies just selected themselves, did they?  The science just happened all by itself, as if by magic, and Ernst is just the guy who told us all what it said, like Moses coming down from the mountain with The Word of God. Yeah, right!

No, Ernst was never a simple messenger, he is an author and an instigator, a collaborator with other anti-CAM extremists and a campaigner against CAM – as Boseley says: “unusually outspoken” and “the scourge of Complementary Medicine”.  Not really what we expected from the first ever Professor of Complementary Medicine, because it is so clearly at odds with the everyday experiences of CAM users.  When those people try to explain that, their views and their attempts to report successes are instantly dismissed just because they did not occur under laboratory conditions.  By contrast, Ernst’s activities are given blanket approval despite the fact that the studies he is looking at never involved any professional CAM therapists and he has never been one himself.

So perhaps the only people who think what he has done is admirable, objective or reliable in any way are the pathological cynics who dismiss ALL complementary therapists as “quacks”.  And those people are in such a small minority that I seriously doubt they could fund his work for very long if they all pitched in together with every penny they have.

No-one else is taking him seriously any more, it seems.  The fact is, we do not need this endlessly negative anti-CAM voice at all, because even if he never published another word on the subject we all know, already, what Edzard Ernst would tell us: “There’s no evidence that it works…” apart from all the millions of people who happily use it, but they don’t count… “…and it could even be dangerous…” although it hardly ever is.  Why would anyone waste their valuable resources generating yet more of that kind of unconvincing drivel after being subjected to seventeen years of it already?  And no-one needs Boseley whining on about it either. “We need this voice” to tell us what to think!  You might, Sarah, but no-one else does, evidently, or people would be willing to fund it without a special appeal from you! (Is there a brain in there anywhere?)

If Ernst and Boseley do find themselves out of work sometime though, I reckon they could get together and reinvent themselves as a Keith Harris and Orville tribute act.  “I wish I could have an original thought, but I can’t!”  “You can!”  “I CAN’T!”

To explain the reference for non-UK dwellers: Ernst could be Keith Harris, a ventriloquist whose dummy is a large and generally clueless baby duck, so of course Edzard provides the voice for both.  And if Boseley doesn’t like the idea of being Orville the duck, maybe she shouldn’t play the role of Ernst’s special media mouthpiece and keep mindlessly repeating the word “quack”.  What goes around comes around Sarah.

Central Hypnotherapy